有创机械通气对ICU重症心力衰竭患者呼吸循环功能及心功能的影响  

Effect of Invasive Mechanical Ventilation on Respiratory,Circulatory,and Cardiac Function of ICU Patients with Severe Heart Failure

作　　者：胡小波[1] Hu Xiaobo(People’s Hospital of Yongcheng City,Shangqiu,Henan,476000,China)

机构地区：[1]河南省永城市人民医院,河南商丘476000

出　　处：《黑龙江医学》2024年第12期1430-1432,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨有创机械通气在ICU重症心力衰竭(HF)患者中的应用效果。方法:选取2020年6月—2022年6月河南省永城市人民医院收治的86例重症HF患者作为研究对象,采用随机数表法分为对照组和观察组,每组各43例。对照组患者给予常规药物治疗,观察组患者在对照组的基础上加用有创机械通气治疗,均于治疗7 d后进行评价。比较两组患者呼吸循环功能、神经内分泌因子水平、心功能及不良心血管事件情况。结果:治疗后,观察组患者动脉血氧分压(PaO_(2))、氧合指数(OI)高于对照组,二氧化碳分压(PaCO_(2))、呼吸频率(RR)较对照组低,差异有统计学意义(t=3.685、5.912、5.854、4.972,P<0.05);治疗后,观察组患者醛固酮(ALD)、心房钠尿肽(ANP)水平低于对照组,皮质醇(COR)高于对照组,差异有统计学意义(t=5.303、4.590、4.418,P<0.05);治疗后,观察组患者左室射血分数(LVEF)高于对照组,左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、血管阻力(SVR)低于对照组,差异有统计学意义(t=5.384、6.772、6.272、4.439,P<0.05);观察组患者不良心血管事件较对照组少,差异有统计学意义(χ^(2)=4.441,P<0.05)。结论:有创机械通气可改善ICU重症HF患者呼吸循环功能,纠正神经内分泌因子紊乱,加快心功能恢复,减少不良心血管事件发生。Objective:To explore the application effect of invasive mechanical ventilation in ICU patients with severe heart failure(HF).Methods:86 severe HF patients admitted to ICU from June 2020 to June 2022 were selected and randomly divided into two groups,with 43 patients in each group.Control group received routine medication treatment,while the observation group received invasive mechanical ventilation treatment.The two groups were evaluated 7 days after treatment.The respiratory and circulatory function,levels of neuroendocrine factors,cardiac function,and adverse cardiovascular events between the two groups were compared.Results:After treatment,the arterial partial pressure of oxygen(PaO_(2))and oxygenation index(OI)in the observation group were higher than those in the control group.Partial pressure of carbon dioxide(PaCO_(2))and respiratory rate(RR)were lower than those in the control group,with statistically significant difference(t=3.685,5.912,5.854,4.972;P<0.05).After treatment,the levels of aldosterone(ALD)and atrial natriuretic peptide(ANP)in the observation group were lower than the control group,while cortisol(COR)was higher than the control group,with statistically significantly difference(t=5.303,4.590,4.418;P<0.05).After treatment,the left ventricular ejection fraction(LVEF)of the observation group was higher than the control group;and the left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),and vascular resistance(SVR)were lower than the control group,with statistically significant difference(t=5.384,6.772,6.272,4.439;P<0.05).The observation group had fewer adverse cardiovascular events compared to the control group,with statistically significant difference(χ^(2)=4.441,P<0.05).Conclusion:Invasive mechanical ventilation can improve respiratory and circulatory function,correct neuroendocrine factor disorders,accelerate cardiac function recovery,and reduce adverse cardiovascular events in ICU patients with severe HF.

关 键 词：重症心力衰竭 有创机械通气 呼吸循环功能 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]